METHOD OF SURGICAL TREATMENT OF CONGENITAL DISLOCATED HIP Russian patent published in 2018 - IPC A61B17/56 

FIELD: medicine.

SUBSTANCE: invention relates to traumatology and orthopedics and may be applicable for the surgical treatment of congenital hip dislocation. Determine the length of the resected area of the proximal femur on the radiograph from the center of the femoral head, which is in the position of the dislocation, to the center of the acetabulum. Spoke is passed perpendicular to the axis of the upper branch of the pubic bone in its outer third, through which a channel is drilled with a hollow drill, converted using a tapered milling cutter into a cone-shaped channel with a diameter of at least 2/3 of the pubic bone, metal rod is installed in the formed channel, carrying out rotational movements for them, and corticotomy of the pubis is performed. Perform intertrochanteric osteotomy of the thigh with the excision of the wedge in the form of a trapezoid, the height of which is equal to the displacement of the femoral head relative to the acetabulum. Arthrotomy of the hip joint is performed with excision of the cicatricial and adipose tissue of the acetabulum bottom, as well as radial dissection of the limbus with the deployment of its edges. Below the anterior edge of the acetabulum, the anterior wall of the ischial bone is distinguished, on the upper part of which a needle is held perpendicular to the axis of the selected bone, a channel is drilled through a needle with a hollow drill; with a conical cutter, a cone-shaped channel is formed, the diameter of which is not less than 2/3 of the thickness of the ischial bone, and the ischemic corticotomy is produced in a manner similar to that of the pubic bone. Perform shortening resection of the proximal femur for a length equal to the displacement of the femoral head relative to the acetabulum. Perform peracetabular osteotomy in the isthmus of the Ilium. Perform open reposition of the femoral head. Osteosynthesis of the proximal femur is performed with a plate, correcting the angle of antetorsion and the cervical-diaphysial angle. Acetabulum is rotated anteriorly, outwards and downwards, displacing it relative to the distal pubic-sciatic fragment to create a hook of “semicircle-semicircle” type, with restoration of normal indicators of the acetabular index and the covering of the femoral head. Stabilize the achieved displacement of the acetabulum by the introduction of bone autograft from the proximal femur to the area of produced acetabular osteotomy. Produce fixation with Kirchner spokes.

EFFECT: method allows to reduce the time of operation, reduce the risk of damage to neurovascular structures.

1 cl, 3 dwg